Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes

Purpose Academic difficulty is reported in children with prolonged post-concussive symptoms. Despite growing evidence that vestibular-ocular and vision-specific dysfunction are common in children following concussion, vision is rarely mentioned in return-to-learn protocols. The purpose of this project was to evaluate a cohort of children with prolonged post-concussive symptoms to determine if vision symptoms are associated with those reporting academic difficulty. Methods Data was obtained from the Children’s of Alabama Concussion Clinic REDCap dataset from the period January 2007 to October 2013. From this dataset of 1,033 concussion events, a cohort of 276 children aged 5–18 years with three or more concussion-related symptoms present for 10 days or more was identified. A cross-sectional cohort study was undertaken to evaluate the association of concussion symptoms, SCAT2 scores, demographic and concussion severity markers to reported educational difficulty among children with prolonged post-concussive symptoms. Univariate and multivariate logistic regression techniques were used to model the association of reported educational difficulty to self-reported vision abnormalities. Results Mean age was 13.8 years. Median time since the concussive event was 21 days, with 33% (95/276) reporting their concussion more than thirty days prior to data collection. Academic difficulty was reported by 29% (79/270) and vision abnormalities in 46% (128/274). After model reduction, vision symptoms (OR 2.17, 95% CI 1.02, 4.62), hearing disturbance (OR 2.39, 95% CI 1.06, 5.36) and concentration difficulty (OR 21.62, 95% CI 9.50, 44.47) remained associated with academic difficulty. For those with symptoms 30 days or more after concussion, only vision (OR 3.15, 95% CI 1.06, 9.38) and concentration difficulty (OR 15.33, 95% CI 4.99, 47.05) remained statistically significant. Conclusions Vision problems were commonly reported in children with concussions and were independently associated with those reporting academic difficulty. Comprehensive vision assessment should be considered in children reporting academic difficulty and in the development of return-to-learn protocols.

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“…22 More recently, this has been extended to non-military mild TBI with an emphasis on sports-related concussion. 9,19,24,33–34 …”

Section: Discussionmentioning

confidence: 99%

“…33 An association between concussion and Attention Deficit Hyperactivity Disorder is also well documented. 34 The direction of this association is however less clear.…”

Section: Discussionmentioning

confidence: 99%

Academic Difficulty and Vision Symptoms in Children with Concussion

Swanson

Weise

Dreer³

et al. 2017

Optom Vis Sci

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“…23 Research has provided evidence for ADHD as an antecedent risk factor for mild traumatic brain injury (mTBI) in college athletes, which complicates diagnosis and treatment. 24 Both LD and ADHD are considered additional risk factors for concussion in the baseline test of the National Football League (NFL) sideline concussion tool. 25 Athletes with LD/ADHD scored lower on computerized neurocognitive tests (CNTs), indicating that separate normative data for these specific populations should be used in concussion management or testing using CNT batteries.…”

Section: Cognitive Disorders As Modifying Factors In Concussion Researchmentioning

confidence: 99%

Cognitive Disorders Among Incoming College Football Athletes: Legal and Medical Implications of Undisclosed Inclusion in Concussion Research

Tatos¹,

Comrie²

2019

JoSPI

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“…56 Interestingly, those with ADHD are actually at higher risk to sustain a concussion, in addition to their risk for prolongation of symptoms. 64 …”

Section: Special Populationsmentioning

confidence: 99%

Pediatric Mild Traumatic Brain Injury in the Acute Setting

Corwin¹,

Grady²,

Joffe³

et al. 2017

Pediatr Emer Care

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Pediatric mild traumatic brain injuries, most of which are concussions, are an increasingly common reason for presentation to emergency departments. The diagnosis of concussion has increased dramatically over the past decade, necessitating the acute care provider to have up-to-date knowledge of the definition, pathophysiology, signs and symptoms, physical examination findings, and acute management of pediatric concussion. This article also addresses populations most vulnerable to prolonged recovery from pediatric concussion and referral recommendations.

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Mild Traumatic Brain Injury and Attention-Deficit Hyperactivity Disorder in Young Student Athletes

Cited by 70 publications

References 35 publications

Academic Difficulty and Vision Symptoms in Children with Concussion

Academic Difficulty and Vision Symptoms in Children with Concussion

Cognitive Disorders Among Incoming College Football Athletes: Legal and Medical Implications of Undisclosed Inclusion in Concussion Research

Pediatric Mild Traumatic Brain Injury in the Acute Setting

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